Comparisons
Semaglutide is a widely used GLP-1 medicine. Eloralintide works on a different hormone pathway. This page lines up what each was and how each was tested, then shows each trial’s own result in its own section, because the two results cannot be ranked.
Different pathways
Semaglutide mimics GLP-1, an incretin hormone. Eloralintide mimics amylin, a hormone released with insulin that slows stomach emptying and signals fullness through the brain. They are not two versions of one idea. See what amylin is for the biology.
How each was tested
The table above sets the two trials side by side by design, not by outcome. The eloralintide trial is a 263-person Phase II study. The semaglutide trial, STEP 1, is a 1,961-person Phase III study. Both enrolled adults with obesity, or overweight with a related condition, who did not have diabetes, and both compared against placebo.
The eloralintide result
At 48 weeks the fixed-dose groups had mean body-weight changes from -9.4% at 1 mg to -20.1% at 9 mg, against -0.4% on placebo, in the efficacy analysis that included all randomly assigned participants. Nausea was reported in 11% to 64% of the dose groups against 14% on placebo. The Phase II page gives every arm.
[Verified V-06, V-08] Figures as already confirmed against the ClinicalTrials.gov results record and the Lancet abstract (2026-09-18, 2026-09-20).
The semaglutide result
In STEP 1, 1,961 adults were assigned two to one to 68 weeks of weekly semaglutide 2.4 mg or placebo, plus lifestyle intervention. The mean change in body weight was -14.9% with semaglutide and -2.4% with placebo, an estimated difference of -12.4 percentage points. Reductions of 5% or more were reached by 86.4% against 31.5%. Stopping treatment because of gastrointestinal events was 4.5% against 0.8%.
[Verified V-51] Figures from the PubMed abstract of Wilding et al., New England Journal of Medicine, 2021 (PMID 33567185, DOI 10.1056/NEJMoa2032183), read 2026-10-02. The abstract states the primary estimand assessed effects regardless of treatment discontinuation or rescue interventions.
Why the two cannot be ranked
One trial lasted 48 weeks and the other 68. One had 263 participants and the other 1,961. One was Phase II and one Phase III, and the analyses were described differently. Any of those differences can move a headline figure, and no trial has randomised people to eloralintide against semaglutide. A reader who wants to know which is better for a person has no answer here, and no honest answer exists on the current record.
What is being tested next
The Phase III ENLIGHTEN studies of eloralintide are registered as placebo-controlled, with primary completion dates in 2028. One of them tests eloralintide added to people already on a weekly incretin treatment, which is a combination question, not a comparison. See the status and timeline page.
What the evidence does and does not allow
It allows a description of two mechanisms and two separate trials. It does not allow a conclusion about which compound is preferable, and it does not support any claim about either for any person. Semaglutide’s current regulatory status and labelling should be read from its own official sources. Eloralintide is investigational and not approved.
Related
See the comparison methodology, eloralintide and tirzepatide and eloralintide and CagriSema.